1. Field of Invention
The present invention relates generally to patient support systems, specifically to cushions that stack for use in supporting both arms of a patient lying on their side.
2. Prior Art
There are a multitude of surgical procedures that require a patient to be lying on their side (laterally) and semi-side (semi-lateral positions) on an operating table where one arm is placed above the other. Unhindered access to the arms and nasopharyngeal (nasal and oral) cavities of the patient during surgical procedures conducted in lateral and semi-lateral positions is critically important for purposes of placement, removal, and maintenance of a multitude of medical devices. For example, medical devices such as vascular access lines, physiological monitoring devices, and tubes are often used. To affect these positions and hold the patient's arms in an extended position generally perpendicular to the torso, both arms are commonly surrounded with towels and other padding; and straps and tape are commonly used to bind both arms to the arm board. Although such padding and encircling binders attach the arms to the arm board, this is not safe and does not buttress the many pressure points of the arms. It is time consuming to set up and highly unsatisfactory and potentially harmful because arm boards are designed to support only one arm. This is illustrated in U.S. Pat. No. 4,045,011 to Ford (1977) and U.S. Pat. No. 5,940,912 to Keselman (1999).
Other time consuming, unsatisfactory, and potentially harmful practices are used to support the upper arm, while still using the arm board to support the lower arm. These include the use of a rollaway table, stand, shelf, and other devices not specifically designed to support the arms.
Still other potentially harmful and time consuming practices to support the upper arm use assemblies constructed of metal and other hard parts consisting of joint couplings and posts that attach a second arm board to the operating table as shown in U.S. Pat. No. 3,046,072 to Douglass, et. al. (1972) or the arm board as described in Hamilton, B. D.: Transperitoneal Laparoscopic Adrenalectomy. Urologic Clinics of North America, 28 (1): page 63, February 2001. Significant injury from bodily contact may result due to contact with one of the many hard parts during placement, positioning and removal of these devices. Injury can also occur as a result of an improperly fixed position of the upper arm relative to the body and from unintended malfunction, potential failure, and collapse of parts.
The prior art is replete with cushions having grooves or ridges that support one arm. U.S. Pat. No. 561,652 to Brownson, et. al. (1896) describes a grooved armrest cushion that supports only one arm of telegraph operators, thereby preventing and alleviating paralysis of the arm. U.S. Pat. No. D321,562 to Ljungvall (1991) describes a grooved arm pillow that supports only one arm for measuring blood pressure. U.S. Pat. Nos. D382,057 (1997), D413,982 (1999), D415,281 (1999), and D426,307 (2000), all to Swedberg, et. al. describe a grooved cushion hand support, a grooved arm positioning splint, a grooved arm with hand positioning splint, and a grooved arm splint with hand positioner, respectively, all being able to support only one arm. U.S. Pat. No. 4,270,235 to Gutmann (1981) describes an arm pillow with ridges on either side designed to support one arm in post-surgical convalescence patients reclining in the spine position. Although the ridges prevent the arm from rolling off the pillow in a manner similar to the operation of grooved cushions, the device is intended to support only one arm.
U.S. Pat. No. 6,622,727 to Perry (2003) describes cushions where a recessed wedge pillow and recessed arm cushions support a head, neck, and both arms. The device is designed to maintain the patient in the “sniffing angle” in the supine position on the operating table for endotracheal anesthesia.
U.S. Pat. No. 6,490,742 to Hall, et. al. (2002) describes a plurality of stackable bolsters for purposes of elevating only one leg or one arm to a desired height.
Heretofore, all prior art devices that we are aware of do not provide well-distributed support, security, safety and padding of the pressure points for both arms, one on top of the other, off the side of the operating table. Furthermore, no prior art device provides access to the arms and nasopharyngeal cavities during surgical procedures performed in these positions.